May 2011 Briefing - Surgery

Here are what the editors at HealthDay consider to be the most important developments in Surgery for May 2011. This roundup includes the latest research news from journal articles, as well as the FDA approvals and regulatory changes that are the most likely to affect clinical practice.

Operative Time of Day Not Tied to Transplant Survival

TUESDAY, May 31 (HealthDay News) -- The operative time of day does not significantly affect one-year survival of thoracic transplant recipients, according to a study published in the June 1 issue of the Journal of the American Medical Association.

TUESDAY, May 31 (HealthDay News) -- Biomarker effects are often overestimated in highly cited studies compared to the effects reported in subsequent meta-analyses of the same associations, according to a review published in the June 1 issue of the Journal of the American Medical Association.

TUESDAY, May 31 (HealthDay News) -- Perioperative registered nurses (RNs) identify communication between the team as the most important factor responsible for near misses or close-call situations that could result in a health care error, according to a study published in the May issue of the AORN Journal.

TUESDAY, May 31 (HealthDay News) -- Significantly shorter renal allograft survival is seen in recipients of kidneys donated by African-American (AA) donors with two apolipoprotein L1 gene (APOL1) risk variants compared to patients receiving a kidney from a donor with zero or one risk variant, according to a study published in the May issue of the American Journal of Transplantation.

FRIDAY, May 27 (HealthDay News) -- Anemia develops in the majority of patients who are hospitalized for intracerebral hemorrhage (ICH), and transfusion of packed red blood cells (PRBC) is associated with improved outcome, according to a study published in the May issue of Neurosurgery.

FRIDAY, May 27 (HealthDay News) -- Hospital Web sites in the United States may be overestimating the benefits and underestimating the risks of robotic surgery, potentially misinforming patients, according to a study published online May 17 in the Journal for Healthcare Quality.

FRIDAY, May 27 (HealthDay News) -- Although the majority of U.K. hospitals have an established pathway for managing head injuries in children, many hospitals are lacking on-site services to care for a critically ill child, according to a study published online May 23 in the Emergency Medicine Journal.

THURSDAY, May 26 (HealthDay News) -- Lateral violence creates an unpleasant work environment affecting nurses, patients, and the health care organization, and, as such, health care centers should educate their nursing staff to identify lateral violence and adopt measures to eliminate it, according to a study published in the May issue of the AORN Journal.

THURSDAY, May 26 (HealthDay News) -- Patients hospitalized for coronary artery disease (CAD) have significantly lower statin adherence following coronary revascularization (percutaneous coronary intervention [PCI] and coronary artery bypass graft surgery [CABG]) than after medical therapy, according to a study published in the May 15 issue of The American Journal of Cardiology.

THURSDAY, May 26 (HealthDay News) -- Delaying radical prostatectomy by six months or more in men who meet the D'Amico low-risk criteria for prostate cancer is correlated with worse outcomes, according to a study published in the June issue of The Journal of Urology.

WEDNESDAY, May 25 (HealthDay News) -- The extent of contact that medical students have with the pharmaceutical industry is associated with positive attitudes about marketing, according to a review published online May 24 in PLoS Medicine.

WEDNESDAY, May 25 (HealthDay News) -- Patients with low back pain in the care of primary care physicians or orthopedists who own or lease magnetic resonance imaging (MRI) equipment are more likely to receive an MRI, according to a study published online April 21 in Health Services Research.

FRIDAY, May 20 (HealthDay News) -- A young man paralyzed from the chest down after an auto accident is able to stand for several minutes after undergoing epidural spinal cord stimulation, according to research published online May 20 in The Lancet.

FRIDAY, May 20 (HealthDay News) -- The majority of medical students lack confidence in their knowledge and skills across many areas of medical law, according to a study published online May 16 in the Journal of Medical Ethics.

FRIDAY, May 20 (HealthDay News) -- Following the adoption of restrictive guidelines for gadolinium-based contrast agent (GBCA) administration, no new nephrogenic systemic fibrosis (NSF) cases have been identified in contrast-enhanced magnetic resonance (MR) examinations, even in patients with a low estimated glomerular filtration rate (eGFR), according to a study published online May 17 in Radiology.

WEDNESDAY, May 18 (HealthDay News) -- In renal-transplant patients at low risk of rejection, biopsy-confirmed acute rejection is less frequent with alemtuzumab than conventional induction therapy, according to a study published in the May 19 issue of the New England Journal of Medicine.

WEDNESDAY, May 18 (HealthDay News) -- Participation in cardiac rehabilitation (CR) after percutaneous coronary intervention (PCI) is associated with a significant decrease in all-cause mortality rates, according to a study published online May 16 in Circulation.

WEDNESDAY, May 18 (HealthDay News) -- Most patients with gastroesophageal reflux disease (GERD) who are treated with esomeprazole therapy or laparoscopic antireflux surgery (LARS) attain remission at five years, according to a study published in the May 18 issue of the Journal of the American Medical Association.

TUESDAY, May 17 (HealthDay News) -- Continuously generating awareness among health care providers of the hospital costs of daily phlebotomy can reduce the amount of phlebotomy ordered for nonintensive care surgical patients and can result in significant savings for the hospital, according to a study published in the May issue of the Archives of Surgery.

TUESDAY, May 17 (HealthDay News) -- Obesity increases the risk of surgical site infection (SSI) after colectomy, which is correlated with an increased cost of treatment, according to a study published online May 16 in the Archives of Surgery.

TUESDAY, May 17 (HealthDay News) -- Implementation of a tele-intensive care unit (ICU) intervention is correlated with reduced mortality risk, length of hospital stay, preventable complications rates, and improvements in best practice adherence, according to a study published online May 16 in the Journal of the American Medical Association.

MONDAY, May 16 (HealthDay News) -- Catheter-related complications for surgical procedures are relatively uncommon, but they are correlated with an increased length of stay and urinary tract infections, according to a study published in the May issue of The Journal of Urology.

MONDAY, May 16 (HealthDay News) -- The quality of deceased-donor organs available for transplantation varies based on characteristics of the transplant center, according to a study published in the May issue of the American Journal of Transplantation.

FRIDAY, May 13 (HealthDay News) -- Use of hydrogel-coated coils (HydroCoil Embolic System [HES]) to treat patients with cerebral aneurysm may reduce the number of angiographic recurrences, but they have no impact on a composite of major angiographic recurrence and clinical status, according to a study published in the May 14 issue of The Lancet.

FRIDAY, May 13 (HealthDay News) -- Use of selective laser photocoagulation of communicating vessels (SLPCV) for patients with twin-twin transfusion syndrome (TTTS) show improved perinatal survival of at least one twin independent of the Quintero stage, according to a study published in the May issue of the American Journal of Obstetrics & Gynecology.

THURSDAY, May 12 (HealthDay News) -- Women who undergo carotid artery stenting may be at higher risk for stroke than those who undergo endarterectomy, but little difference is seen between men who undergo one of the two blockage clearing procedures, according to research published online May 6 in The Lancet Neurology.

THURSDAY, May 12 (HealthDay News) -- Metropolitan statistical areas (MSAs) usually have higher rates of firearm-related homicides than the national average, and the rate in youths exceeds the all-ages rate in most MSAs and cities, according to a report in the May 13 issue of the U.S. Centers for Disease Control and Prevention's Morbidity and Mortality Weekly Report.

THURSDAY, May 12 (HealthDay News) -- Patients with clinical stage II to III estrogen receptor (ER)-positive breast cancer who undergo preoperative treatment with the aromatase inhibitors (AIs) exemestane, letrozole, or anastrozole have improved surgical outcomes, according to a study published online May 9 in the Journal of Clinical Oncology.

THURSDAY, May 12 (HealthDay News) -- In the United States, women have worse cardiovascular treatment and outcomes than men, according to the Women's Health in American Hospitals report released on May 3 by HealthGrades.

THURSDAY, May 12 (HealthDay News) -- Laparoscopic Heller's myotomy (LHM) appears no more effective than pneumatic dilation for treatment of achalasia, according to research published in the May 12 issue of the New England Journal of Medicine.

WEDNESDAY, May 11 (HealthDay News) -- Use of mesh to repair anterior vaginal wall prolapse appears to result in better outcomes than traditional colporrhaphy at one year, but mesh is associated with more complications and postoperative adverse events, according to research published in the May 12 issue of the New England Journal of Medicine.

WEDNESDAY, May 11 (HealthDay News) -- Although most medical professionals believe that commercial funding of continuing medical education (CME) introduces bias, most are not willing to pay higher fees to offset or eliminate such funding sources, according to a study published in the May 9 issue of the Archives of Internal Medicine.

WEDNESDAY, May 11 (HealthDay News) -- The relative cost-effectiveness of immediate office-based probing surgery (IOPS) and deferred facility-based probing surgery (DFBS) for treatment of nasolacrimal duct obstruction in infants depends on the rate of spontaneous resolution, according to a study published in the May issue of the Archives of Ophthalmology.

TUESDAY, May 10 (HealthDay News) -- Patients with ST-segment elevation myocardial infarction (STEMI) who undergo successful reperfusion may not benefit from a single intravenous bolus of epoetin alfa within four hours of percutaneous coronary intervention (PCI), according to a study published in the May 11 issue of the Journal of the American Medical Association.

TUESDAY, May 10 (HealthDay News) -- Less than half the patients with stable coronary artery disease (CAD) undergoing percutaneous coronary intervention (PCI) receive optimal medical therapy (OMT) before PCI; whereas, approximately two-thirds receive it following PCI, with similar practice patterns seen before and after publication of the Clinical Outcomes Utilizing Revascularization and Aggressive Drug Evaluation (COURAGE) trial, according to a study published in the May 11 issue of the Journal of the American Medical Association.

MONDAY, May 9 (HealthDay News) -- The majority of patients with adolescent idiopathic scoliosis (AIS) report experiencing back pain, and those who perceive themselves as less deformed or have less of a desire to change their spinal deformity have a greater reduction in pain after posterior spinal fusion surgery, according to a study published in the May 1 issue of Spine.

FRIDAY, May 6 (HealthDay News) -- Treatment of acute uncomplicated appendicitis with amoxicillin and clavulanic acid is not as effective as emergency appendectomy, according to a study published online May 7 in The Lancet.

FRIDAY, May 6 (HealthDay News) -- Brief anesthetic exposure during a surgery in infancy does not reduce academic performance in adolescence, according to a study published in the May issue of Anesthesiology.

THURSDAY, May 5 (HealthDay News) -- Following medial facetectomy, use of Auxiliary Facet System (AFS) instrumentation has a minor influence on flexion/extension and lateral bending, stabilizes axial rotation, and reduces intradiscal pressure (IDP), according to a study published in the April 20 issue of Spine.

THURSDAY, May 5 (HealthDay News) -- Although cardiac catheterization in children has inherent risks, it can be used for diagnosis and treatment of several heart conditions, according to a scientific statement by the American Heart Association published online May 4 in Circulation.

THURSDAY, May 5 (HealthDay News) -- In children with obstructive sleep apnea syndrome (OSAS), sleep-disordered breathing improves after adenotonsillectomy possibly due to decreases in the sympathetic activity of the autonomic nervous system, according to a study published in the May issue of Chest.

THURSDAY, May 5 (HealthDay News) -- A condition-specific comorbidity index may be significantly better than the commonly used Deyo Comorbidity Index for adjusting mortality, morbidities, and hospital disposition measures, according to a study published in the April 20 issue of Spine.

WEDNESDAY, May 4 (HealthDay News) -- After 15 years, radical prostatectomy appears to be associated with a reduction in the rate of death from prostate cancer as compared to watchful waiting, according to a study published in the May 5 issue of the New England Journal of Medicine.

TUESDAY, May 3 (HealthDay News) -- Coronary artery bypass graft (CABG) utilization rates in the United States decreased significantly between 2001 and 2008, but percutaneous coronary intervention (PCI) utilization rates remained unchanged, according to a study published in the May 4 issue of the Journal of the American Medical Association.

TUESDAY, May 3 (HealthDay News) -- Elderly patients who undergo surgery for scoliosis have an increased risk of complications but may experience greater improvement in disability and pain than younger patients, according to a study published in the May 1 issue of Spine.

TUESDAY, May 3 (HealthDay News) -- Despite the absence of a pediatric medical emergency team (PMET), researchers at a Canadian hospital found a decrease in hospital mortality over time, a finding they attribute less to their lack of a PMET than to the limitations of before-and-after study designs; their research has been published in the May issue of the Archives of Pediatrics & Adolescent Medicine.

MONDAY, May 2 (HealthDay News) -- Histological changes in the first five years after allogenic renal transplantation are generally mild, and are less severe than previously reported, according to a study published in the April issue of the American Journal of Transplantation.

MONDAY, May 2 (HealthDay News) -- Lumbar total disc arthroplasty is a viable alternative to arthrodesis for the treatment of two-level degenerative disc disease, according to a study published in the April 20 issue of The Journal of Bone & Joint Surgery.